Abstract P528: Acute Kidney Injury Increases Mortality in Patients With Upper Gastrointestinal Hemorrhage (UGIB) and Acute Coronary Syndrome: A Population Based Study

Abstract

Background: Upper GI Bleeding (UGIB) is a common emergency with a relatively high incidence in the general population. Acute Coronary Syndrome (ACS) is often overlooked in gastrointestinal bleeding as its symptoms and signs are often subtle. Purpose: This study aims to compare the outcomes of patients admitted for ACS with and without UGIB. Methods: Data were extracted from the National Inpatient Sample (NIS) 2016-2019 Database. The NIS was searched for hospitalizations for adult patients with ACS as the principal discharge diagnosis with and without UGIB as the secondary diagnosis using ICD-10 codes. The primary outcome was inpatient mortality. Multivariate logistic and linear regression analysis was used accordingly to adjust for confounders. STATA software was used for analysis. Results: Among 35,740 patients who had ACS, 463 (1.3%) patients had UGIB. The adjusted odds ratio (OR) for inpatient mortality for ACS with UGIB compared to those without UGIB was higher (OR 1.94, p<0.0001), length of stay was 4.27 days longer (p<0.0001), and total charges were $55,479 higher (p<0.0001). The Independent positive predictors of increased mortality were: Acute kidney injury (AKI) (p<0.0001). Independent positive predictors of LOS and total charges were the following: Coronary artery bypass graft surgery (CABG), Intra-aortic balloon pump (IABP) insertion, AKI (p<0.0001) Conclusion: UGIB patients with ACS did have higher inpatient mortality. A positive predictor of mortality included the presence of concomitant AKI. Thus, the prevention of AKI Is of utmost importance. Further, larger studies are warranted to identify new risk factors as predictors of mortality and improve awareness of GI bleeding risk and decrease LOS.